Pregnancy Risk Assessment Monitoring System
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Pregnancy Risk Assessment Monitoring System
description
Pregnancy Risk Assessment Monitoring System . Background/Relevance. Infant mortality rates were no longer declining Incidence of low birth weight infants had changed little Research indicated that maternal behaviors during pregnancy may influence infant birth weight and mortality rates. - PowerPoint PPT Presentation
Transcript of Pregnancy Risk Assessment Monitoring System
Pregnancy Risk Assessment Monitoring System
Background/Relevance
Infant mortality rates were no longerdeclining
Incidence of low birth weight infants had changed little
Research indicated that maternal behaviors during pregnancy may influence infant birth weight and mortality rates
1987 -
What is PRAMS?
Ongoing, population-based, state-based surveillance system of women delivering live infants
Self-reported data on maternal behaviors and experiences before, during, and after pregnancy
Goal
To improve the health of mothers and infants by reducing adverse outcomes such as low birth weight infant morbidity and mortality maternal morbidity
History of PRAMS: 1987
OK
IN
MI
ME
WV
TX
DC
States Participating in PRAMS, 2006
OK
AK
GA
FL
SCAL
NC
CO
NM AR
IL
NY
ME
WV
WA
LA
UTOH
NE
HI
VT
MD
NYC
MS
OR MN
MI
TX
RINJ
WYWISD
PA
TN
MO VADE
MA
Prior to 2006
Newly funded
in 2006
Note: With the addition of 9 new states, PRAMS will represent approximately 75% of all US live births
Strengths of PRAMS
Strong methodology Standardized protocol Data weighted to reflect population of live
births in the stateResponse rates ≥70%
90% of states 4 states ≥80%
Unique source of MCH data State-based and population-based
Challenges
Overall response rates ≥70% Mail & phone
Racial/ethnic populations Native American African American Hispanic
Flexibility May need to change/enhance methodology
Challenges
Timeliness Data timeliness indicated as most significant
challenge to policy and program development Weighted datasets back to states
States and CDC share responsibility Frequency of changing questions on survey Lack of efficient data management system
Data to Action
Use of PRAMS data to promote public health action
2 examples: Policy/Law
Alaska- breastfeeding Program
Utah – adequacy of prenatal care Colorado – low birth weight
Alaska - Breastfeeding
Initiation 1991 – 79.1% 2001 – 90.6%
Utah: Prenatal care adequacy
Evaluation of postpartum
women to see if ads changed their attitudes and actions
“Baby your baby” media
campaign
Utah ranked 49th in adequacy of PNC
----61% received adequate PNC
versus US average of 74%
Analyzed state data
Women unaware of PNC
recommendations, didn’t value PNC
Focus groups of
women with inadequate
PNC
Colorado – Low Birth Weight
Social Marketing Campaign Launched
“A Healthy Baby is Worth the Weight”
Collaboration with
stakeholders
Supplementedwith
focus groupdata
Prevalence of LBW 8.9%
Analyzed CO
PRAMS data
Report Published
“Weighing in on the Solution to
the LBW Problemin CO”
+
New indicators added to
PRAMS & BC
Training of nurses and educators
Campaign expanded to other states
Data to action
Characteristics of states able to use data for public health action Staff to analyze data Strong collaborations
Within health department MCH community
Skilled in working with program staff and policy makers
Champion Provide TA to states to strengthen these
skills
MCH Data Linkage Project
Goal: To promote collaboration between MCH and chronic disease/health promotion professionals by:
Increasing awareness of the value of PRAMS data with Chronic Disease/Health Promotion Directors
Identifying issues of mutual concern in PRAMS Working together to address
those issues
MCH Linkage Project Partners
CDC PRAMS DRH (Division of Reproductive Health)
NACDD (National Association for Chronic Disease Directors)
AMCHP (Association of Maternal and Child Health Programs)
State MCH/PRAMS and chronic disease/health promotion professionals
Why Link?
Preconception care is important, especially for women with chronic diseases Risk factors and conditions can be identified
and addressedPregnancy can unmask a potential for
diseasePregnancy is an entry point into health
care and an opportunity for primary prevention
ChronicDisease
MCH
Example: Tobacco Prevention and Control Programs
Utah persuaded Medicaid clinics to cover counseling and cessation costs
Designed media campaign and Quit Line strategies to target this population
Use maternal smoking and second- hand smoke exposure data to design,
implement and evaluate programs
Future Directions
Data collection in 9 new statesQuestionnaire evaluation/revision
Phase 5 (2004-2008) Phase 6 (2009+)
Overhaul of PRAMS data management systems
Methods to increase response rates in hard to reach populations
Future Directions
Increased dissemination of data State accessed query system Public use query system
Increased utilization of data for public health action
Expand Chronic Disease Linkage Project
